Exploring community participation in project design: application of the community conversation approach to improve maternal and newborn health in Zambia.
BMC Public Health
; 17(1): 277, 2017 Mar 23.
Article
em En
| MEDLINE
| ID: mdl-28335751
ABSTRACT
BACKGROUND:
The United Nations Development Programme (UNDP) has adopted an approach entitled Community Conversation (CC) to improve community engagement in addressing health challenges. CCs are based on Paulo Freire's transformative communication approach, in which communities pose problems and critically examine their everyday life experiences through discussion. We adopted this approach to engage communities in maternal and newborn health discussions in three rural districts of Zambia, with the aim of developing community-generated interventions.METHODS:
Sixty (60) CCs were held in three target districts, covering a total of 20 health facilities. Communities were purposively selected in each district to capture a range of rural and peri-urban areas at varying distances from health facilities. Conversations were held four times in each community between May and September 2014. All conversations were digitally recorded and later transcribed. NVivo version 10 was used for data analysis. RESULTS ANDDISCUSSION:
The major barriers to accessing maternal health services included geography, limited infrastructure, lack of knowledge, shortage of human resources and essential commodities, and insufficient involvement of male partners. From the demand side, a lack of information and misconceptions, and, from the supply side, inadequately trained health workers with poor attitudes, negatively affected access to maternal health services in target districts either directly or indirectly. At least 17 of 20 communities suggested solutions to these challenges, including targeted community sensitisation on the importance of safe motherhood, family planning and prevention of teenage pregnancy. Community members and key stakeholders committed time and resources to address these challenges with minimal external support.CONCLUSION:
We successfully applied the CC approach to explore maternal health challenges in three rural districts of Zambia. CCs functioned as an advocacy platform to facilitate direct engagement with key decision makers within the community and to align priorities while incorporating community views. There was a general lack of knowledge about safe motherhood and family planning in all three districts. However, other problems were unique to health facilities, demonstrating the need for tailored interventions.Palavras-chave
Texto completo:
1
Temas:
ECOS
/
Estado_mercado_regulacao
Bases de dados:
MEDLINE
Assunto principal:
Comunicação
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Planejamento em Saúde Comunitária
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Participação da Comunidade
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Serviços de Saúde Materno-Infantil
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Acessibilidade aos Serviços de Saúde
Tipo de estudo:
Clinical_trials
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Prognostic_studies
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Qualitative_research
Aspecto:
Determinantes_sociais_saude
Limite:
Adolescent
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Adult
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Female
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Humans
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Male
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Newborn
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Pregnancy
País/Região como assunto:
Africa
Idioma:
En
Revista:
BMC Public Health
Assunto da revista:
SAUDE PUBLICA
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Zâmbia